Document Detail

Corpus callosotomy: a quantitative study of the extent of resection, seizure control, and neuropsychological outcome.
MedLine Citation:
PMID:  8410248     Owner:  NLM     Status:  MEDLINE    
Corpus callosotomy is valuable for controlling medically intractable generalized seizures in appropriate patients, but postoperative development of language disorders, neuropsychological impairment, and motor dysfunction have all been noted. The extent of callosum resection has been implicated as a possible determinant of outcome, but this hypothesis has not been formally tested. Analysis of the records of all patients who underwent corpus callosotomy at the University of California, San Francisco, from 1986 to 1991 showed that, of 15 patients who underwent anterior or complete callosotomy, seven were entirely or nearly seizure-free, four had at least a 50% reduction in seizure frequency, and four had no change. To determine callosal size and extent of callosotomy, preoperative and postoperative magnetic resonance images were measured with computer-based planimetry. Seizure outcome was not significantly associated with preoperative callosal size or extent of callosotomy. Intelligence quotient scores did not change significantly after callosotomy. No severe neuropsychological deficits developed after anterior or complete callosotomy, even in patients with mixed cerebral dominance or bilateral language representation. These results indicate that division of the anterior one-half to two-thirds of the corpus callosum is nearly as effective as more extensive anterior sectioning or complete callosotomy in reducing drop-attack and generalized tonic-clonic seizures in appropriate patients, and that the extent of callosotomy is not an important factor on outcome when at least 50% to 65% of the callosum is divided. Mixed cerebral dominance and other unusual patterns of language and memory organization do not appear to increase the postoperative risk for neuropsychological deficits, regardless of the extent of anterior section.
A N Mamelak; N M Barbaro; J A Walker; K D Laxer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  79     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-11-17     Completed Date:  1993-11-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  688-95     Citation Subset:  AIM; IM    
Department of Neurological Surgery, University of California School of Medicine, San Francisco.
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MeSH Terms
Corpus Callosum / physiopathology,  surgery*
Dominance, Cerebral
Magnetic Resonance Imaging
Neuropsychological Tests
Retrospective Studies
Seizures / physiopathology,  surgery*
Comment In:
J Neurosurg. 1994 Aug;81(2):328-9   [PMID:  8027822 ]

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